CMS/EIP Fiscal Report Center: 07
Services beginning 10/01/2020 ending 12/31/2020 Date of Report:01/23/2021 Page: 1
List order: No List
Agency Filter:EIP DEI DEIP
Payclass Filters:GR
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 1501 2174.750000 80282.7500 36.9159
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 70 78.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 451 1238.000000 45723.2500 36.9332
Subtotal (Total Children Is Unduplicated) 1573 3490.750000 126006.0000 36.0971
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 28 33.500000 1675.0000 50.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 2 4.000000 222.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 2 4.000000 300.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 45 90.000000 4995.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 16 31.000000 1720.5000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 21 41.500000 3112.5000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 9 18.000000 1350.0000 75.0000
Subtotal (Total Children Is Unduplicated) 106 222.000000 13375.0000 60.2477
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 52 78.500000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 52 78.500000 0.0000 0.0000
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Total 3791.250000 139381.0000 36.7639
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Number of Children (Unduplicated) With at Least One Service 1588
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Center 07
Flag Claims Units Chgs Paid
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R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 17 16.500000 838.5000 0.0000
S 0 0.000000 0.0000 0.0000
H 6 11.500000 805.5000 0.0000
T 0 0.000000 0.0000 0.0000
7113 3763.250000 137737.0000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 7136 3791.250000 139381.0000 0.0000